0001104659-14-009588.txt : 20140213 0001104659-14-009588.hdr.sgml : 20140213 20140213114905 ACCESSION NUMBER: 0001104659-14-009588 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20140211 FILED AS OF DATE: 20140213 DATE AS OF CHANGE: 20140213 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Egalet Corp CENTRAL INDEX KEY: 0001586105 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 463575334 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 101 LINDENWOOD DRIVE STREET 2: SUITE 225 CITY: MALVERN STATE: PA ZIP: 19355 BUSINESS PHONE: 484-875-3095 MAIL ADDRESS: STREET 1: 101 LINDENWOOD DRIVE STREET 2: SUITE 225 CITY: MALVERN STATE: PA ZIP: 19355 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: INDEX VENTURES LIFE VI (JERSEY) L.P. CENTRAL INDEX KEY: 0001591199 STATE OF INCORPORATION: Y9 FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36295 FILM NUMBER: 14604048 BUSINESS ADDRESS: STREET 1: OGIER HOUSE STREET 2: THE ESPLANADE CITY: ST. HELIER STATE: Y9 ZIP: JE4 9WG BUSINESS PHONE: 44-1534-504000 MAIL ADDRESS: STREET 1: OGIER HOUSE STREET 2: THE ESPLANADE CITY: ST. HELIER STATE: Y9 ZIP: JE4 9WG REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Yucca (Jersey) SLP CENTRAL INDEX KEY: 0001591294 STATE OF INCORPORATION: Y9 FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36295 FILM NUMBER: 14604049 BUSINESS ADDRESS: STREET 1: OGIER HOUSE STREET 2: THE ESPLANADE CITY: ST. HELIER STATE: Y9 ZIP: JE4 9WG BUSINESS PHONE: 44-0-1534-833400 MAIL ADDRESS: STREET 1: NO. 1 SEATON PLACE CITY: ST. HELIER STATE: Y9 ZIP: Y9 JE48YJ REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Index Ventures III Parallel Entrepreneur Fund (Jersey) L.P. CENTRAL INDEX KEY: 0001503681 STATE OF INCORPORATION: Y9 FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36295 FILM NUMBER: 14604050 BUSINESS ADDRESS: STREET 1: NO. 1 SEATON PLACE CITY: ST. HELIER STATE: Y9 ZIP: JE4 8YJ BUSINESS PHONE: 441534605643 MAIL ADDRESS: STREET 1: NO. 1 SEATON PLACE CITY: ST. HELIER STATE: Y9 ZIP: JE4 8YJ REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Index Ventures III (Delaware) L.P. CENTRAL INDEX KEY: 0001402023 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36295 FILM NUMBER: 14604051 BUSINESS ADDRESS: STREET 1: C/O AEGERION PHARMACEUTICALS, INC. STREET 2: 1140 ROUTE 22 EAST, SUITE 304 CITY: BRIDGEWATER STATE: NJ ZIP: 08807 BUSINESS PHONE: (908) 704-1300 MAIL ADDRESS: STREET 1: C/O AEGERION PHARMACEUTICALS, INC. STREET 2: 1140 ROUTE 22 EAST, SUITE 304 CITY: BRIDGEWATER STATE: NJ ZIP: 08807 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Index Ventures III (Jersey) L.P. CENTRAL INDEX KEY: 0001503686 STATE OF INCORPORATION: Y9 FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36295 FILM NUMBER: 14604052 BUSINESS ADDRESS: STREET 1: NO.1 SEATON PLACE CITY: ST. HELIER STATE: Y9 ZIP: JE4 8YJ BUSINESS PHONE: 441534605643 MAIL ADDRESS: STREET 1: NO.1 SEATON PLACE CITY: ST. HELIER STATE: Y9 ZIP: JE4 8YJ REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Index Venture Associates III Ltd CENTRAL INDEX KEY: 0001503683 STATE OF INCORPORATION: Y9 FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36295 FILM NUMBER: 14604053 BUSINESS ADDRESS: STREET 1: NO. 1 SEATON PLACE CITY: ST. HELIER STATE: Y9 ZIP: JE 8YJ BUSINESS PHONE: 441534605643 MAIL ADDRESS: STREET 1: NO. 1 SEATON PLACE CITY: ST. HELIER STATE: Y9 ZIP: JE 8YJ 4 1 a4.xml 4 X0306 4 2014-02-11 0 0001586105 Egalet Corp EGLT 0001503683 Index Venture Associates III Ltd NO. 1 SEATON PLACE ST. HELIER Y9 JE4 8YJ JERSEY 0 0 1 0 0001503686 Index Ventures III (Jersey) L.P. NO. 1 SEATON PLACE ST. HELIER Y9 JE4 8YJ JERSEY 0 0 1 0 0001402023 Index Ventures III (Delaware) L.P. NO. 1 SEATON PLACE ST. HELIER Y9 JE4 8YJ JERSEY 0 0 1 0 0001503681 Index Ventures III Parallel Entrepreneur Fund (Jersey) L.P. NO. 1 SEATON PLACE ST. HELIER Y9 JE4 8YJ JERSEY 0 0 1 0 0001591294 Yucca (Jersey) SLP NO. 1 SEATON PLACE ST. HELIER Y9 JE4 8YJ JERSEY 0 0 1 0 0001591199 INDEX VENTURES LIFE VI (JERSEY) L.P. NO. 1 SEATON PLACE ST. HELIER Y9 JE4 8YJ JERSEY 0 0 1 0 Common Stock 2014-02-11 4 C 0 148950 A 148950 D Common Stock 2014-02-11 4 C 0 83377 A 232327 D Common Stock 2014-02-11 4 C 0 44207 A 276534 D Common Stock 2014-02-11 4 X 0 23284 0.001 A 299818 D Common Stock 2014-02-11 4 C 0 28242 6 A 328060 D Common Stock 2014-02-11 4 C 0 66450 6 A 394510 D Common Stock 89227 I By Egalet A/S Common Stock 2014-02-11 4 C 0 302576 A 302576 D Common Stock 2014-02-11 4 C 0 169372 A 471948 D Common Stock 2014-02-11 4 C 0 89800 A 561748 D Common Stock 2014-02-11 4 X 0 47298 0.001 A 609046 D Common Stock 2014-02-11 4 C 0 57370 6 A 666416 D Common Stock 2014-02-11 4 C 0 134988 6 A 801404 D Common Stock 181256 I By Egalet A/S Common Stock 2014-02-11 4 C 0 5390 A 5390 D Common Stock 2014-02-11 4 C 0 3017 A 8407 D Common Stock 2014-02-11 4 C 0 1600 A 10007 D Common Stock 2014-02-11 4 X 0 842 0.001 A 10849 D Common Stock 2014-02-11 4 C 0 1021 6 A 11870 D Common Stock 2014-02-11 4 C 0 2403 6 A 14273 D Common Stock 3229 I By Egalet A/S Common Stock 2014-02-11 4 C 0 3685 A 3685 D Common Stock 2014-02-11 4 C 0 2062 A 5747 D Common Stock 2014-02-11 4 C 0 1093 A 6840 D Common Stock 2014-02-11 4 X 0 3500 0.001 A 10340 D Common Stock 2014-02-11 4 C 0 698 6 A 11038 D Common Stock 2014-02-11 4 C 0 9991 6 A 21029 D Common Stock 2603 I By Egalet A/S Common Stock 2014-02-11 4 X 0 192076 0.001 A 192076 D Common Stock 2014-02-11 4 C 0 548186 6 A 740262 D Series A-2 Preferred Stock 2014-02-11 4 C 0 148950 0 D Common Stock 148950 0 D Series B Preferred Stock 2014-02-11 4 C 0 83377 0 D Common Stock 83377 0 D Series B-1 Preferred Stock 2014-02-11 4 C 0 44207 0 D Common Stock 44207 0 D Warrants 0.001 2014-02-11 4 X 0 23284 0 D Common Stock 23284 0 D Subordinated Convertible Debt 6 2014-02-11 4 C 0 169452 0 D Common Stock 28242 0 D Senior Convertible Debt 6 2014-02-11 4 C 0 398711 0 D Common Stock 66450 0 D Series A-2 Preferred Stock 2014-02-11 4 C 0 302576 0 D Common Stock 302576 0 D Series B Preferred Stock 2014-02-11 4 C 0 169372 0 D Common Stock 169372 0 D Series B-1 Preferred Stock 2014-02-11 4 C 0 89800 0 D Common Stock 89800 0 D Warrants 0.001 2014-02-11 4 X 0 47298 0 D Common Stock 47298 0 D Subordinated Convertible Debt 6 2014-02-11 4 C 0 344224 0 D Common Stock 57370 0 D Senior Convertible Debt 6 2014-02-11 4 C 0 809939 0 D Common Stock 134988 0 D Series A-2 Preferred Stock 2014-02-11 4 C 0 5390 0 D Common Stock 5390 0 D Series B Preferred Stock 2014-02-11 4 C 0 3017 0 D Common Stock 3017 0 D Series B-1 Preferred Stock 10 2014-02-11 4 C 0 1600 0 D Common Stock 1600 0 D Warrants 0.001 2014-02-11 4 X 0 842 0 D Common Stock 842 0 D Subordinated Convertible Debt 6 2014-02-11 4 C 0 6132 0 D Common Stock 1021 0 D Senior Convertible Debt 6 2014-02-11 4 C 0 14427 0 D Common Stock 2403 0 D Series A-2 Preferred Stock 2014-02-11 4 C 0 3685 0 D Common Stock 3685 0 D Series B Preferred Stock 2014-02-11 4 C 0 2062 0 D Common Stock 2062 0 D Series B-1 Preferred Stock 2014-02-11 4 C 0 1093 0 D Common Stock 1093 0 D Warrants 0.001 2014-02-11 4 X 0 3500 0 D Common Stock 3500 0 D Subordinated Convertible Debt 6 2014-02-11 4 C 0 4192 0 D Common Stock 698 0 D Senior Convertible Debt 6 2014-02-11 4 C 0 59953 0 D Common Stock 9991 0 D Warrants 0.001 2014-02-11 4 X 0 192076 0 D Common Stock 192076 0 D Senior Convertible Debt 6 2014-02-11 4 C 0 3289131 0 D Common Stock 548186 0 D These securities are owned, as indicated, by Index Ventures III (Jersey), L.P. ("Jersey"), Index Ventures III (Delaware), L.P. ("Delaware"), or Index Ventures III Parallel Entrepreneur Fund (Jersey) L.P. ("Index PEF"), of which Index Venture Associates III Ltd. ("Index Associates") is the general partner, or Yucca (Jersey) SLP ("Yucca") or Index Ventures Life VI (Jersey) L.P. ("Index VI"), of which Index Associates is an affiliate. Index Associates, Jersey, Delaware, Index PEF, Yucca and Index VI (collectively, the "Index Entities") are members of a "group" for purposes of Section 13(d) of the Exchange Act. This Form 4 is being filed jointly by the Index Entities in connection with the consummation of Egalet Corporation's initial public offering. Each of the Index Entities disclaims beneficial ownership of the securities held of record by any of the other Index Entities, except, in each case, to the extent of their respective proportionate pecuniary interest(s) therein. The reporting person is Egalet A/S, a corporation. Jersey, Delaware, Index PEF and Yucca are 6.90%, 14.03%, 0.25% and 0.20% equityholders of Egalet A/S, respectively. These securities are owned by Jersey. These securities are owned by Delaware. These securities are owned by Index PEF. These securities are owned by Yucca These securities are owned by Index VI. The Series A-2 Preferred Stock automatically converted into Egalet Corporation common stock on a 1-for-1 basis immediately prior to the consummation of Egalet Corporation's initial public offering. The Series B Preferred Stock automatically converted into Egalet Corporation common stock on a 1-for-1 basis immediately prior to the consummation of Egalet Corporation's initial public offering. The Series B-1 Preferred Stock automatically converted into Egalet Corporation common stock on a 1-for-1 basis immediately prior to the consummation of Egalet Corporation's initial public offering. The warrants were automatically exercised into Egalet Corporation common stock immediately prior to the consummation of the Egalet Corporation's initial public offering on a 1-for-1 basis, pursuant to the securityholders' purchase of a specified minimum amount of common stock in such offering. The subordinated convertible debt automatically converted into Egalet Corporation common stock immediately prior to the consummation of Egalet Corporation's initial public offering, based on a conversion price equal to 50% of the per share price in such offering, which was $12 per share. The senior convertible debt automatically converted into Egalet Corporation common stock immediately prior to the consummation of Egalet Corporation's initial public offering, based on a conversion price equal to 50% of the per share price in such offering, which was $12 per share. By: Stan Musial, Attorney in fact for Index Venture Associates III Ltd. 2014-02-13 By: Stan Musial, Attorney in fact for Index Ventures III (Jersey), L.P. 2014-02-13 By: Stan Musial, Attorney in fact for Index Ventures III (Delaware), L.P. 2014-02-13 By: Stan Musial, Attorney in fact for Index Ventures III Parallel Entrepreneur Fund (Jersey) 2014-02-13 By: Stan Musial, Attorney in fact for Yucca (Jersey) SLP 2014-02-13 By: Stan Musial, Attorney in fact for Index Ventures Life VI (Jersey) L.P. 2014-02-13